Friday, 13 July 2012

I'm Sorry.

After almost 6 months of being a resident, this is the one thing that's still pretty difficult to deal with: Telling the father or mother of a child that their kid is either terminal, hopeless, or just not going to be their same old son or daughter anymore.

It's an emotional rollercoaster that's always different with each family. There's no routine to how it works or what you're supposed to do. I'm sure abroad there's a whole system or class teaching you how to deal this particular piece of information out but here, it's just an afterthought.

Which sort of sucks.

It's gotten to a point where I jump at the possibility of delivering bad news to families because I feel I'm the only one equipped with the ability to emotionally convey bad news and at the same time, share the emotional fuckage the family experiences. I don't think I'm better than my colleagues at it. I just think that they've been at this longer than I have, and that they've reached a certain jaded level of consciousness I'm not sure I'm ever going to get to... or want to at least.

It's also a whole lot harder to do than say, telling the family their kid died. There's a finality to death. But with terminal illness or affection, I always feel like I'm damning them to both feel the loss of their child profoundly but also hope that maybe, through some sort of God given miracle, their kid will be the 0.0005 percent that miraculously becomes okay.

And man, do they stick to that hope. Because after all, "God is almighty and works in mysterious ways."
I sometimes thank God that I don't have to deal with atheists and agnostics. It becomes a whole lot easier to accept when the doctor says something like "Well, God is here and this is what He wanted to happen so who are we to judge."

And I feel like a prick every single time I say that because it works every.single.time.

So yay for Egypt not having any atheists.

Another one that's always harsh is "Was there anything that could have been done to prevent this? Was it my fault doctor? Was I too late? Did I do something wrong?"

I pride myself in honesty, but goddamnit does that become a whole lot harder when I say, a single shot of Vitamin K could have saved their newborn from having intracranial hemorrhage and subsequent brain atrophy for the rest of their life.

And I tell them that. But I also tell them it's never their fault (unless it's aspiration pneumonia, ESPECIALLY after I've told them not to fucking breastfeed their kid but that's a whole other story entirely).

After all, ignorance is rather rampant here as you might have sussed out from my previous blogposts.

I have a few stories about a few of these moments and I might or might not share all of them here but here's one that really did a number on me.

We had a 10 year old girl who got admitted into the hospital for having pancytopenia (all blood cells, including Red , white and platelets are decreased) Now, there are alot of causes for pancytopenia but we usually screen out leukemia first by doing a bone marrow aspirate and sometimes biopsy. So we managed to book her aspirate a few days later and I remember going upstairs to the labs to pick up her report.

She had leukemia.

I'm not going to lie. I felt nothing reading the paper at first. To me, this was just another girl who had cancer and we were going to tell her parents that and then she was going to go on to the Cancer Hospital and get her treatment and then maybe get better, or maybe not.

Pretty standard stuff.

But then I bumped into her father, who had been waiting for hours outside the lab for the test results.

"Did the results come out Doc?"

His eyes were wide open, full of worry and anxiety.

"Yes, let's sit down first."

So we sat on the bench in the hallway.

"Well, your daughter, she has leukemia."

"You mean cancer?"

"Yes."

Then and there he just broke down in tears, as if crushed by this immense weight. Not as if. He was, and there I was, sitting next to a crying middle aged man who just found out his 10 year old girl had cancer.

I felt like shit.

I felt like shit because I felt nothing a few seconds prior to seeing him, and now here I was, just emotionally syncing with him and feeling every ounce of sadness seep out of him.

That's a lie, because obviously I couldn't even experience a fraction of what he was feeling, and even that small fraction was already too much for me.

"It's not the end of the world. It's tough. It's going to be very tough, but I've seen kids with leukemia go into remission and get better and move on with their lives and become healthy individuals."

"So you're saying she's going to be alright?"

I fucking hate that question.

".......... Listen. We're all going to do our best here. You're going to do what you can and the doctors are going to do what they can, and well, the rest we can leave to God. Okay?"

He was still crying.

So I hugged him.

Might have not been the by the book thing to do. Might have not even been the right thing to do.

But there we were; two sad men sitting on a bench trying to get through life's hurdles.

2 comments:

My sister passed along your blog to me, and I must tell you, I have quite enjoyed going back and reading your posts! I work in pediatric intensive care, and while our hospitals are wildly different, the plight of humanity is pretty much the same. Please continue to share...

This brought tears to my eyes. Sometimes the "not by the book" thing is what people need. It's bad enough to hear a cancer diagnosis..but it's worse to hear it from a cold, uninterested doctor..yes, the doctor may have repeated this to multiple people but to the one person hearing it for the first time..it's devastating. So yes..a hug was definitely the right thing to do. Never feel bad about being compassionate and not hiding it.